extends life of elderly with cancer
Elderly late-stage cancer patients who received home care from advanced practice nurses lived 22 months longer than patients who received standard care, says a study led by a School of Nursing (YSN) researcher.
In the two-year study, which was published in the Dec. 4 Journal of the American Geriatrics Society, researchers followed 375 elderly patients newly discharged from the hospital after cancer surgery. Some patients received standard care while an experimental group received three home visits and five telephone contacts with an advanced practice nurse, who also educated family members about caregiving. Advanced practice nurses are specially trained registered nurses, usually holding master's degrees, who can provide such highly skilled care as medication prescription and physical examinations.
"These findings tell us a great deal about the role of nurses," says the study's lead author, Ruth McCorkle, who is professor at YSN and chair of its doctoral program.
"Traditionally we have thought of nurses as making patients more comfortable, thus improving quality of life," adds McCorkle, who is also director of YSN's Center for Chronic Illness. "This study shows that good nursing not only improves but extends life. Imagine what a breakthrough it would be to find a drug that bought cancer patients almost two years of high quality time. Well, we've found something that can extend life that dramatically, and it's not a drug that requires a long and expensive approval process before patients can benefit from it."
As the study data was examined, it became obvious that the patients receiving the advanced nursing care were living longer, says McCorkle. This was especially surprising, she adds, since the patients in the experimental group were sicker overall than the patients receiving standard care. In fact, the sickest patients seemed to benefit most from the advanced practice nursing, she notes.
The study focused on elderly patients, who are more likely to experience post-operative complications. This problem is exacerbated by a trend to discharge patients rapidly after surgery, explains McCorkle. The interventions of the advanced practice nurse served to avert or address complications rapidly, she says. In contrast, some patients in the standard care group died prematurely from surgical complications, such as infections. The authors speculate that survival may also have been enhanced in the experimental group by the psychosocial support that nurses gave patients and families.
The study was funded by the National Institute for Nursing Research, one of the National Institutes of Health. Other researchers participating were Neville E. Strumpf of the University of Pennsylvania, Diane C. Adler of Temple University, Isaac F. Nuamah of Bristol-Meyers, Mary E. Cooley of YSN, Christopher Jepson of the University of Pennsylvania, Edward J. Lusk of Fox Chase and Michael Torosian of the University of Pennsylvania.
-- By Karen Peart
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